Prepare for the Downstream Effects of ICD-10
When ICD-10 was implemented in Canada 10 years ago, coding efficiency dropped significantly. In an interview with Healthcare IT News Cynthia Grant, Director of Canadian consultancy Courtyard Group stated that productivity in Canada never rebounded to ICD–9 levels following the ICD-10 implementation. Based on analysis of the Canadian experience, many anticipate U.S. coder productivity to decline 20-50 percent. The looming 2013 deadline for U.S. healthcare facilities to implement ICD-10 is causing concern among HIM professional for its impact on operations.
According to the AAPC, diagnostic codes will expand dramatically from 13,500 to more than 69,000 specific classifications. The change in procedural codes is no less significant; they will balloon from 4,000 in ICD-9 to more than 72,000 in ICD-10. This major change in code sets is expected to impact efficiency in the health information management (HIM) department for the foreseeable future.
The Hybrid Records’ Negative Impact on Efficiency
Without doubt, ICD-10 is today’s hot topic. Unfortunately, other issues that will affect the transition and the revenue cycle are lacking attention in the marketplace. One such topic is how a hybrid medical record, a chart comprised of paper and electronic documents or existing in multiple locations, will impact ICD-10 coding and DNFB.
When the switch is flipped to ICD-10 coding, processing a hybrid chart could potentially cripple a health information management (HIM) department that is already behind in scanning medical records. Delays in scanning cause delays in dropping the bill; this compounded by ICD-10 will create inefficiency in many HIM departments.
Alternatively, hospitals that have eliminated their reliance on paper are better prepared for ICD-10. Their efficient scanning practices and electronic environment allows for the utilization of electronic workflow to route records to and from coders with greater efficiency. The ability to share documents electronically between HIM and clinical staff enables deficiencies to be corrected faster and charts to be completed and sent to coding more rapidly.
When eliminating paper medical records by scanning charts within 24 hours of discharge and processing electronically, HIM leaders, coders, and clinicians will all have simultaneous access to the chart. Coders will have access to the chart remotely, which enables HIM leaders to hire the most knowledgeable staff regardless of geographic location.
In today’s world of more to do with fewer resources, deciding where to focus time and attention is often difficult. Although it might seem like adding one more thing to the to-do list, now is the time to analyze the impact of a partially paper chart and make proactive changes to prepare for the future. Eliminating the paper now may very well limit the headache later.
